| NPI | 1528113768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD 00041053) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: WA MD00041053) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-09-20 |